Healthy Hormones
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SHBG Test – How to Interpret Your Results and What to do With Them

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​SHBG is short for Sex Hormone Binding Globulin​.

This test is rarely ordered, which is unfortunate because it can give you a lot of information about the hormones in your body.

​High levels can ​lead to symptoms of excess estrogen, excess thyroid, and low testosterone.

Low levels can lead to symptoms of low thyroid, low estrogen, and excess testosterone.

​In this article, I will ​discuss how to interpret your SHBG test results, and ​list some common causes of elevated levels and low levels.  

I will show how SHBG can be used to monitor your thyroid function if you are on thyroid medication.

​I will also discuss some things that you can do to help you get your SHBG level back into the optimal range​ whether it is high or low...

More...

​What is SHBG?

​SHBG is an acronym for sex hormone binding globulin.

It does what it sounds like it does - it binds up sex hormones.

Why is that important?

In order to understand this better we need to discuss how hormones work in general.

​The vast majority of hormones in your body are bound to proteins in the bloodstream.  This helps to stabilize the hormone so it can get to the targeted cells all over the body.

While it is bound, however, it is inactive and not available for the cells to use.

​In order for the hormone to be active, it must break away from the protein.  This makes it a "free" hormone and it can then enter the cells and turn on the cellular function it is designed to do.

This is called the Free Hormone Hypothesis.

The "free" hormones are therefore the "active" hormones.

The ​amount of "free" hormones is much smaller than the amount of "bound" hormones.

This protein binding is one of the ways that the body uses to regulate the hormone ​levels.

So what about SHBG?

SHBG levels naturally ​increase as we age.  Since ​most hormone levels naturally decline as well, this makes a deficiency of those hormones (especially testosterone) even more pronounced.


​Sex Hormone Binding Globulin binds to several different hormones.  The body uses SHBG to ​inactivate these hormones in the bloodstream.

Too much of it can be bad because it can bind so much of the hormone that we can have symptoms caused by a ​lack of that hormone.

Too little can also be bad because it can cause an excess of certain hormones which ​also causes symptoms.

Even small changes in SHBG can cause substantial symptoms and problems.

SHBG has a stronger affinity for some hormones that others.

It will preferentially bind to sex hormones in this ​order (from highest affinity to lowest):

  • Dihydrotestosterone (DHT)
  • Testosterone
  • Androstenediol
  • Estradiol
  • Estrone

​As you can see, SHBG has a greater affinity for androgens than estrogens.

​You can therefore predict the symptoms you may have by knowing the effect that the SHBG level has on your androgen levels.

For example, if you have an elevated SHBG, it will bind DHT and testosterone which will cause symptoms of low testosterone (weight gain, depression, increased belly fat, loss of muscle, etc.).

With low levels of SHBG, you will have more unbound or free testosterone which will cause symptoms of high testosterone (acne, facial hair growth, PCOS, etc).

Hopefully you can see why it's important to check your SHBG level if you are having any symptoms of hormonal imbalance to help you and your doctor determine what issues are going on in your body.

The optimal range for SHBG is 60-80 nmol/L.  Any level below or above this range should be investigated.

​​Elevated SHBG Test

There are several things that I will list below that can elevate SHBG levels.

​Most of these occur because they affect​ one of these 2 hormones in the body​ - Estrogen and thyroid​ hormone.

An increase in either or both of these hormones will stimulate the liver to increase SHBG production.

A SHBG level > 80 nmol/L is considered too high.

​​Common Causes of ​Elevated SHBG

​Another hormone to keep in mind that is closely linked to SHBG is cortisol.

Cortisol is our stress hormone.  In times of increased stress (physical or mental), our adrenal glands increase cortisol production.  

​An elevated cortisol level stimulates the liver to increase SHBG production.

​Symptoms of Elevated SHBG

​Please realize that an elevated level of SHBG does not in itself cause any symptoms.

The symptoms are caused by the effect that the high SHBG level has on hormones in the body.

Most of the symptoms will be due to either excess estrogen and/or low testosterone:

  • Menstrual Irregularities
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    Weight Gain (pear shape type)
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    Mood Swings
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    Breast Tenderness
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    Loss of Muscle Mass
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    Fatigue
  • Fluid Retention

If the elevated SHBG is caused by the situation of a high thyroid level (hyperthyroidism or excessive oral thyroid medication), you can also have symptoms related to the elevated thyroid such as tremor, palpitations and weight loss.

​How to Treat an Elevated SHBG

​Treating an elevated SHBG has more to do with finding the cause of the elevation rather than treating the elevated SHBG itself.

There are several things you should consider doing:

1.  Check your Estrogen and Progesterone Levels -

​The ratio of these 2 hormones is more important than the numbers themselves.

Check the levels in the middle of your cycle (2 weeks after your last period) for the best results.

If the ratio of estrogen:progesterone is >10:1, you have estrogen dominance that needs to be addressed.

​2. Check Your Thyroid Levels -

If your estrogen level is normal, then it is highly likely that your thyroid is the culprit of your elevated SHBG.

Check a complete thyroid panel, especially free T3 and free T4.

If these are elevated and you are on thyroid medication, you may need to lower your dose or even change your thyroid medication.

If you aren't on thyroid medication, you need to have more testing done ASAP to find the cause of your elevated thyroid (most likely Grave's Disease).

3.  Stop Smoking!
4.  If you are on oral birth control pills, consider using another form of birth control -
​5.  Work on Stress Management -

I discuss several techniques to better manage your stress in my article on Adrenal Fatigue.

​Low SHBG Test

​Low SHBG is more difficult to detect and often harder to treat.

As a result, it is often ignored much more than an elevated SHBG.

Common Causes of Low SHBG

​A low SHBG typically occurs in menopausal women or patients with hypothyroidism (low thyroid).

​So if your SHBG is ​< 60 nmol/L, you should look at estrogen and thyroid as the probable causes if you are menopausal.

If you are still menstruating, then hypothyroidism is the likely cause.

If one or both of those hormones is low, SHBG levels will drop which will increase free testosterone, paving the way for conditions such as PCOS.

This series of hormone imbalances also ​appears to set up a person to develop insulin resistance.

In fact, a low SHBG level has been shown to be a strong predictor for type 2 diabetes in both men and women.

​Symptoms of Low SHBG

​The symptoms associated with a low SHBG are typically caused by low thyroid hormone, low estrogen, and elevated testosterone.  The include:

  • Weight Gain
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    ​Menstrual Irregularities
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    Fatigue
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    Hot flashes
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    Acne
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    Facial Hair Growth
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    Hair loss
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    Depression

​Keep in mind that your individual symptoms will depend on which hormones are out of balance and to what extent.

​Treatment of Low SHBG

​If you have a low SHBG, you should consider the following things:

​1.  Check a complete thyroid panel -
  • TSH
  • free T4
  • free T3
  • reverse T3
  • TPO antibodies
  • thyroglobulin antibodies

​Compare these tests with their optimal levels to determine if you have a thyroid issue.

If your thyroid function is low, it is probably affecting your SHBG level and you will need to consider taking a thyroid medication and doing other things to help boost your thyroid function.

​2.  Check your estrogen/progesterone ratio if you are menopausal- 

After menopause, your estrogen levels will drop which can drop your SHBG level.

If that is the case in your situation, you might need to consider bioidentical hormone replacement therapy.

​3.  Check your free testosterone level - 

If your SHBG level is low, there will be less of it to bind to testosterone, so it may cause your free testosterone level to rise.

This can usually be alleviated by maximizing your thyroid medication which will raise your SHBG level.

​How the SHBG Test Can Be Used to Monitor Thyroid Function

​One final benefit of checking your SHBG level is it a good indicator of the thyroid function in your body.

In states of low thyroid function, the SHBG level drops.

In states of high thyroid function, the SHBG level rises.

This allows the SHBG to be used as a marker to assess the thyroid hormone absorption and cellular function.

If you have low SHBG and hypothyroidism, you should test your SHBG level at the beginning of treatment to assess if you are on the right type of thyroid hormone and the right amount.

If you are taking a T4 only thyroid medication and your SHBG level does not increase, you may have a problem with peripheral conversion of T4 into active T3.

You therefore may need to change to a natural dessicated thyroid (NDT) or add T3 to your current regimen.

On the flip side, if after starting your thyroid medication your SHBG level rises > 80 nmol/L, that is an indication that your dose is too high and it should be reduced.

​Summary

​The sex hormone binding globulin level gives us important information on the status of several hormones in the body.

​A high level is typically caused by estrogen excess and excess cortisol.

​A low level is typically caused by low thyroid.  It also is an indicator that you may be having issues with insulin resistance.

The key to treating an abnormal SHBG level is to identify what is causing the abnormality and correct it.

Doing this will help return the SHBG level to the optimal range and reduce symptoms.

​Now it's your turn...

Do you have an abnormal SHBG level?

Have you identified the cause or causes?

Please leave your comments below.

About the Author Dr. Jeff Whelchel

Dr. Whelchel is a family physician who specializes in functional medicine, especially hormone optimization. He has over 20 years experience in private practice managing patients with various medical issues. His passion is helping patients reach their full potential of wellness and quality of life. He grew up in the Texas Panhandle where he currently lives. He is married and has 3 awesome children.

Leave a Comment:

37 comments
NF says December 24, 2017

Female 38 years: TSH 2.22, FT4 1.2, FT3 2.5, SHBG 24.75…is my SHBG considered low?

Reply
    Dr. Jeff Whelchel says January 1, 2018

    Yes, that is a low SHBG. It is probably low from your thyroid being low (your free T3 should be around 4). I don’t know your estrogen or testosterone levels, so they could be affecting it as well.

    Reply
Rachael Kurtz says February 2, 2018

Hey,
I’m taking daily oral contraception. My recent blood work came back as FSH 0.4, LH 0.2, Testosterone 1.6 and SHBG 438. Is this consistent for someone on the pill?

Reply
    Dr. Jeff Whelchel says February 3, 2018

    Hi Rachael. Yes, birth control bills will make the SHBG level go sky high. That can in effect lower your testosterone.

    Reply
candice says February 21, 2018

My SHBG results were high at 167.2 and my Free Testosterone is just on the boarder of being low at .4, however, my Free T4 is borderline low at 1.0. My doctor gave me a RX of Armour Thyroid 30mg and I have felt soooo much better. The weird thing is Ive read if you have low SHBG that usually means your thyroid is low and high doesn’t. I have more of they symptoms for low SHBG than high. My T3 is 2.8, my Estradiol is 69.1 and my Progesterone is 10.13. I’m a 34 year old female and I know increasing my thyroid is for sure helping but I feel like I need to decrease my SHBG. Sorta stumped.

Reply
    Dr. Jeff Whelchel says February 24, 2018

    Hi Candice. If you are on any kind of hormone replacement therapy with estrogen, if will raise your SHBG levels. In fact, it makes checking your SHBG level of no use if you are taking an estrogen of some sort. Smoking will also raise it.

    Reply
      Candice says February 24, 2018

      No, I’m not on any hormone replacement or I have never smoked. My doctor has me now on a natural thyroid which has helped me tremendously and just put me on something to help my estradiol go up since my free testosterone was low. Sorta opposite when your SHBG is high usually you have to much thyroid I believe but for me I was very low and have been feeling so much better since on a natural thyroid medicine.

      Reply
Brittany says February 27, 2018

I’m a 28 yr old female with SHBG in 200s. On day 21 of cycle: Progesterone = 8.7 Estradiol= 138 Test= 26 Free Test = 1.1. This is after I started compounded testosterone cream, DIM, Boron, and a lot of liver flushing/cleansing. What else can I do to lower it? I deal with cellulite and very low muscle tone.

Reply
    Dr. Jeff Whelchel says February 27, 2018

    Hi Brittany. I would consider evaluating your stress and improving your stress management. You may want to get some adrenal testing done such as the DUTCH test or even salivary cortisol levels to get an idea of what your cortisol is running throughout the day. I assume you don’t smoke and aren’t on some type of birth control pill. Both of those will make the SHBG go very high.

    Reply
      Brittany says February 27, 2018

      Thanks Dr. Whelchel. I have Lyme and CIRS (mold toxicity). Well I’ve been out of mold for over two years now and have done extensive Lyme work and detox such as PK protocol and more. Liver used to be fatty from all of the mycotoxins found in my urine but have reversed that with intensive liver programs. Is it safe to say this could be from my liver? Also should I try compounded progesterone cream? Seems that if my adrenals are stressed there’s probably some progesterone steal happening.

      Reply
        Dr. Jeff Whelchel says March 11, 2018

        Anything that is increasing the inflammation in your body could be affecting your SHBG. I think you are on the right track. You may want to discuss it further with your doctor.

        Reply
Kt says March 26, 2018

Hi, I am currently taking aldactone 100mg for acne. I am wanting to stop the medication and have noticed horrible side effects such as facial hair. I was not dx with pcos. I had lab work per my gyn and I know
My shbg is low. She says she cannot help me. What about my other tests. What can I do to help with my problem. I cannot see the internist or endo until August since I am a new patient 🙁 33 year old 140lb, no health history.
Dht-50.1
Testosterone -12, shbg-28, free test 2.2, dheas 205, progesterone <0.10, hydroxylrogesterkne 22.60, androstenedione 0.609, tsh 2.56, estradiol 61, fab 5.8,/lo 3.2, prolactin 20.8( drawn on day 7 cycle)

3 months prior
Tsh 4.1853 and t4 0.95

Reply
    Dr. Jeff Whelchel says April 8, 2018

    Low SHBG is usually caused by either low estrogen or low thyroid. In your case, estradiol does seem to be a little bit low. However, you also need a complete thyroid panel to better assess your thyroid function. That would include a free T3, reverse T3, and thyroid antibodies.

    If you are suffering from acne and facial hair, I would be suspect that you have PCOS.

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Debbie Beesley says April 19, 2018

hello. I really appreciate your writing on SHBG. I just got tested & I have high SHBG, it is 109. But I have not yet had follow up w/my doctor, next week. Still I am wondering what could be cause of this high SHBG and have read about it I am post menopausal, age 64. About 8 years ago I purposely lost 100+ lb & have maintained it since then with exercise & careful eating. What does SHBG have to do with weight loss/insulin ? I eat well & am active. I swim or walk daily. I am thinking perhaps this high SHBG has to do with cortisol. I don’t know so I am asking your thoughts. I have also lost almost all my hair in past 4 years. It was long now it is very short. Any insight or thoughts appreciated: Here are test results numbers:
Testost SerPl-mCnc 56 ng/dL 2-45 High
Testost Free SerPl-mCnc 2.4 pg/mL 0.2-5.0 Normal
Testost Bioavail SerPl-mCnc 4.7 ng/dL 0.5-8.5 Normal
SHBG SerPl-sCnc 109 nmol/L 14-73 High
Glucose SerPl-mCnc 84 mg/dL 65-99 Normal
BUN SerPl-mCnc 25 mg/dL 7-25 Normal
TSH SerPl-aCnc 2.64 mIU/L 0.40-4.50 Normal

Reply
    Dr. Jeff Whelchel says April 22, 2018

    Hi Debbie. I don’t have near enough information to know what is actually causing your elevated SHBG. Extreme weight loss could be the culprit. I don’t know if you are on any type of hormone replacement therapy, but that could do it. If you smoke that could also do it. If you have a lot of stress, that can also raise the SHBG level.

    The first thing I recommend is getting your estradiol and progresterone levels checked. If you ratio of estradiol to progesterone is > 10:1, you have estrogen dominance as the cause. You also need a complete thyroid panel, not just a TSH. You can learn more about that in several of the articles on my website.

    Hair loss can also be a sign of stress, low thyroid, sex hormone imbalance, or low ferritin. You need a much more complete evaluation.

    I hope this helps. Good luck.

    Reply
      Debbie Beesley says April 23, 2018

      I really appreciate you taking the time to answer. Doctors like you, as you know, are rare. . I did get Ferritin test, thats normal. I’m not in HRT, no smoking, and i like the idea of thyroid testing further T3 or T4, ? right?

      Reply
        Dr. Jeff Whelchel says April 24, 2018

        Yes, you need a free T4, free T3, reverse T3, TPO antibodies and thyroglobulin antibodies.

        Reply
Mindy says April 23, 2018

Hey! Thank you for the great read! I am now even more confused if and what is going on with my body. I got my lab tests back and I’m not sure how i feel about them. Tsh 0.64 ft4 0.92 ft3 3.4 pg/ml. Never had any antibodies and i eat nature throid. My cortisol from blood is 446 nmol/l. Estradiol is 0.65 nmol/l (right before periods), Free testosterone is 11 pmol/l, shbg is 46nmol/l. I dont know what to make out from these. I dont have birthcontrol pills anymore. I quit them about 2 years ago. I have really low libido the past 4 years and i used to be really fine with that before. It’s a strain for the marriage and I’m only turning 30. Thanks for your help! 🙂

Reply
    Dr. Jeff Whelchel says April 26, 2018

    Hi Mindy. Based on the results you shared, you may want to ask your doctor to check your progesterone and free testosterone levels. Your thyroid levels may be slightly low as well.

    Reply
Anna says May 4, 2018

My TSH was 8, free T3 and free T4 both low-normal. Have not yet started thyroid replacement hormone, but SHBG 140 and free testosterone is 61.

Reply
    Dr. Jeff Whelchel says May 5, 2018

    Hi Anna. That is an extremely high level for a free testosterone. Are you sure you don’t mean total testosterone? Your thyroid are definitely low. You should also ask to get your estradiol and progesterone levels checked.

    Reply
Ms. B says May 22, 2018

Hello Dr. Whelchel,
I am an 46 yr. old female with concerns around my numbers.
Total Testosterone 28.0; Free Testosterone 1.9; SHBG 121.5 as I understand it my SHBG is considered low, is this correct?.

Reply
    Dr. Jeff Whelchel says May 23, 2018

    Hello. Actually, that SHGB level is high, not low. Any level above 80 is considered high. As the article explains, that high of an SHBG level is usually due to smoking, oral birth control pills, hyperthyroidism, or extreme weight loss. Without seeing your other lab results and not knowing your medical history, it is impossible for me to know why. I would get with your doctor to help you determine the cause in your particular situation. Take care.

    Reply
Sarah says May 26, 2018

Hello! First, I would like to say that I appreciate how you respond to comments on this page. I recently got blood work done, and was wondering if my numbers seemed off to you, or if anything jumped out. These were my initial thoughts, but I am not a doctor.

TSH .99
T4 1.00
I thought maybe this might be weird- isn’t a low TSH usually indicative of higher T4 levels?

SHBG 39 Does this strike you as particularly low?

Fasting glucose 95
Insulin 5.6 (normal) Seemed weird to me that my fasting glucose was pretty high but insulin results don’t point to insulin resistance.

Prolactin 22.5 Not sure if this is a high number or not. I am not pregnant.

a.m. Cortisol levels were flagged as high, at 24.7 mcg/dL

Testosterone free 2.8
Testosterone bioavailable 5.5

I have noticed some abnormal, thick black body hair. I think PCOS was thrown around several times, but no diagnosis yet.

Just wondering your thoughts! Thank you

Reply
    Dr. Jeff Whelchel says June 3, 2018

    Hello Sarah. Looking at the results you sent me, it is hard to form an opinion. You need a complete thyroid panel, including thyroid antibodies, reverse T3, and free T3. Your SHBG is lower than ideal (should be 60-80).

    Any fasting insulin > 5 is considered high. Your glucose and insulin were both slightly higher than optimal, which points to some early insulin resistance.

    Your cortisol level is also high. I am assuming that you are under a lot of stress. If not, that should be investigated further.

    I would sit down with your doctor so that he or she can investigate your situation more closely, including your menstrual cycle and other symptoms that you might not have related to your hormones.

    Good luck!

    Reply
BB says July 9, 2018

Hi Dr. Jeff – thanks for reading. My dr. keeps telling me that my levels are normal but I’m still having symptoms. I’m female 33 yrs old experiencing light facial hair, hair on upper arms where I never had it before, lower back, stomach and chest area – it’s not thick or coarse but definitely visable. The texture of my hair is thinner and straight whereas it used to be very glossy and thick with lots of body. It’s stringy now and i have a lot less of it, but no bald spots.
Testosterone Total LCMSMS – 18 NG/dL;Testosterone Free 3.1pg/ML;Testosterone Bio 6.5ng/dL;SHBGnmol/L;Albumin4.6g/DL
DHEA Sulfate-181 mcg/dL
TSH T4- 1.10mIU/L
Thyroid Peroxidase AB<1iu/ml
Prolactin 11.2 ng/mL

Reply
    Dr. Jeff Whelchel says July 25, 2018

    Hi Bianca. You listed some of your results but not all. You need to get a SHBG level, free T3, thyroglobulin ab, reverse T3, TSH level, and estradiol. I would suggest you find a doctor that is comfortable with managing these results and possibly PCOS (beyond just giving metformin). You need to sit down, discuss your symptoms, and develop a game plan. Good luck!

    Reply
kevin says July 17, 2018

Hi Dr Jeff, appreciate your responses to all comments here and great read by the way!

I am a 35 year old male, 69kg, 168cm, relatively fit and healthy individual.
SHBG (74.8nmol/L)
Total testosterone (29.1nmol/L)
Free testosterone (0.366nmol/L)

My concern is that my libido/sexual desire for the last 20+ years (since puberty) has remained steady/high. Around November/December 2017 i noticed my sex drive/interest had dropped, EQ also dropped..dismissed this and assumed it was all in my head.

In Jan 2018 my optician carried out an OCT scan on my right eye and diagnosed it with macular edema (fluid build up the back of my retina) The only advice i was given was to improve my diet, give it time and avoid using anabolic steroids (questioned if i was) and eventually my condition would improve…… I’ve never taken steroids in my life and i wouldnt know where to start so naturally was confused with this response…. Fast forward 7 months and my eye has fully healed, but my sex drive and libido still seems to be very low!

Can you shed some light as to why i would have high SHBG and high/within range total test and free test? would this be a cause for concern/low libido,

greatly appreciate your help/advice!

Reply
    Dr. Jeff Whelchel says July 25, 2018

    Hi Kevin. Sorry you are having some troubles.

    Your total testosterone is indeed pretty good. Your free testosterone could stand to be a little higher. You might try taking some DIM 300mg daily which will help increase it.
    Otherwise I would suggest you get a complete hormone evaluation. This would include estradiol, complete thyroid panel, insulin and leptin. These can also affect libido, as can stress from work, in the marriage, etc. Good luck!

    Reply
Diane says August 3, 2018

Hi Dr. Jeff,
Here are my hormone luteal phase salivary results:
Estradiol 11.3
Estrone17.5
Estriol <70
Testosterone <30
Progesterone 1280
P/e2 ratio 113
Salivary cortisol 7-9 am .456
11-1 .056
3-5 pm .078
10-12 am .021
Thyroid levels:
Tpo antibodies 0.6
Thyroxine bind 19
T3free 3.6
Free t4 1.09
Tsh. .82
T3reverse 21

What do you see? Biggest concerns? I have two nodules which measure 2.5+.
I am positive for ebv and Lyme.
Thanks for your expertise in these areas. Diane

Reply
    Dr. Jeff Whelchel says August 16, 2018

    Diane, I have very little experience with interpreting salivary hormone results. I only use serum results. I would suggest you sit down with the doctor that ordered the test to get more information and answers. Good luck.

    Reply
Anne Bushell says August 8, 2018

Age 59 6 mos
SHBG 125.4
Free Testosterone (direct) 0.3
Testerone serum 19
Albumin 4.3

I eat healthy, exercise and do intermittent fasting
BMI is 26

I do have a hard time losing weight
I’m not stressed out (most of the time) and I take adaptogens daily.
Dr. Is checking hormones because of low libido.

What are your thoughts?

Reply
    Dr. Jeff Whelchel says August 16, 2018

    Hi Anne. You need a complete thyroid workup. I would also want to know if you are on some type of birth control pill or hormone replacement therapy. Both can increase the SHBG substantially. You also need your liver assessed. Other causes of a high SHBG include smoking and some seizure medications.

    Needless to say, all of this needs to be evaluated by your doctor. Good luck!

    Reply
Kim says September 7, 2018

My T4 is 1.93, what dr Co spiders “slightly elevated”. I have been experiencing higher BP, palpitations and anxiety which all began with an ER visit due to gabapentin interaction (very high BP) with vitamins & supplements. Dr drew blood today to test hormones & cortisol levels & said will check SHBT based on what those tests show. Have bee on 10 mg propranolol for 4 weeks. BP is down some but still lots of palpitations, which leads to anxiety. Have Xanax for the really bad times but feel I need answer that are too slow coming to underlying problems. Have lost weight and feel yucky. What are your suggestions?

Reply
    Dr. Jeff Whelchel says September 9, 2018

    Hi Kim. So sorry to hear about your troubles. I would definitely wait to get the lab results from your doctor. I would in particular rule out heart issues completely before overly focusing on your hormones. I think you should wear a heart monitor for a few days to see if you can identify what type of rhythm issue is causing your palpitations. Good luck!

    Reply
Paul says September 30, 2018

Hi, Dr. Whelchel.

I am a 46 old male, 180 lbs, 6 feet and 1 inch, relatively fit and healthy individual.

SHBG: 67.7 nmol/L
Total Testosterone: 533.3 ng/dL
Free Testosterone: 66.67 pg/mL
Albumin: 4.6 g/dL
Estradiol: 39.9 pg/mL
Prolactin: 6.5 ng/mL
FSH: 4.3 mIU/mL
LH: 2.5 mIU/mL

In the past two years I have experienced a drop in my libido (that worsened in the past 9 months). Besides, I began to feel tired quite often (lack of energy).

The first doctor I went to told me that it was probably due to stress (from emotional/psychological reasons). I considered the possibility, after all, I have been subject to a certain amount of stress in the past years (mostly due to family issues).

The second one (an endocrinologist) asked for the exams whose results are in the beginning of this message and due to my age she suggested that I should try taking Tribulus Terrestris for one month and see how I would feel.

After a few days taking TT (280 mg once a day) I began feeling better and some of my previous libido returned, but after one month I did a second exam and my numbers doesn’t seem to have improved very much (and some worsened).

SHBG: 71.8 nmol/L
Total Testosterone: 586.9 ng/dL
Free Testosterone: 71.57 pg/mL
Albumin: 4.5 g/dL
Estradiol: 47.0 pg/mL

Since then I stopped taking TT and up to this time I could not set another appointment with her.

Some people have told me that I should think about hormone therapy. Do you believe I should consider any other kind of exam besides these I already did?

Thank you very much for all the information on this page.

Reply
    Dr. Jeff Whelchel says October 6, 2018

    Hi Paul. Your labs are not horrible, but you still might consider testosterone therapy. You could either get injections or pellet therapy. Your symptoms might improve if you could get your testosterone level up over 900.

    Reply
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